Brain aneurysm

A brain aneurysm, also called a cerebral aneurysm, is a condition whereby there is a bulging, weak area in the wall of an artery that supplies blood to the brain. Brain aneurysms occur in approximately three to six percent of the population. Fortunately, many of these are small and go unrecognized throughout life and do not rupture. Other times, a brain aneurysm ruptures, leading to a subarachnoid hemorrhage, which releases blood into the skull and causes a stroke. Brain damage and even death may result, depending on the severity of the hemorrhage.

The Northwell Health Institute for Neurology and Neurosurgery combines advanced technical knowledge and cutting-edge procedures for diagnosing and treating ruptured and non-ruptured aneurysms and related conditions. Our team of specialists provides thorough neurological evaluations using the latest diagnostic technology including CT angiography and 3D angiography. We work very closely with the departments of neurosurgery, interventional neuroradiology, neurology and radiation oncology, as well as other specialists, to ensure an accurate diagnosis and the appropriate treatment for the best outcome.

An aneurysm can grow for years without any symptoms or signs. The symptoms may appear only when the aneurysm ruptures, blocks the flow of blood or grows large enough to press on nearby body parts. Symptoms can include:

• A drooping eyelid
• Blurred or double vision
• Confusion
• Loss of consciousness
• Nausea and vomiting
• Seizure
• Sensitivity to light
• Stiff neck
• Sudden, extremely severe headache

Brain aneurysms are thought to arise from a congenital defect in the wall of an artery. However, certain risk factors can contribute to aneurysm formation and the possibility of rupture. Such risks include:

• Hypertension
• Smoking
• Alcohol use
• Family history
• Inherited disorders, such as Ehlers-Danlos syndrome, polycystic kidney disease, Marfan syndrome and neurofibromatosis

An unruptured aneurysm is typically found incidentally during an unrelated neurological workup or CT or MRI of the brain. Once an aneurysm has been located, a more detailed workup may be required. It is important for your physician to understand the size, shape, location and origin of an aneurysm. This will help to determine how it should be treated. Most of the tests are safe, painless and noninvasive. These include:

• Computerized tomography (CT)
• Computed tomography angiography (CTA)
• Magnetic resonance angiography (MRA)
• Angiography
• 3D angiography
• Transcranial doppler ultrasonography

The following are some ways an aneurysm can be treated:

• Intracranial bypass
• Excimer laser assisted non-occlusive anastomosis (ELANA)
• Lenox bypass™
• Pipeline embolization device (PED)
• Laser-assisted cerebral bypass surgery
• Cerebral bypass surgery
• Endovascular coiling
• Aneurysm clipping
• Endovascular embolization
• Craniotomy to remove AVM
• Flow re-direction endoluminal device (FRED™)
• Sclerotherapy of facial vascular malformations
• Carotid artery stenting and carotid endarterectomy
• Mechanical thrombectomy for acute stroke

Your brain aneurysm treatment risks will vary depending on the type of treatment, the size and type of your aneurysm and your general health. Your physician will discuss any potential risks and side effects with you ahead of your treatment.

Once your brain aneurysm treatment has been completed, you may require rehabilitation to help you regain some skills and capabilities. Your healthcare team will recommend and coordinate the right type of therapy for your specific needs.